Good negotiations can depend on finding the right approach to the issues.
In 2002, the leadership of a large New Jersey hospital became concerned about ethnic tensions between patients and staff. The patients, mainly Hispanic, were complaining about insensitive, rude, and sometimes discriminatory treatment by the doctors. Nearly 80 percent of the doctors were immigrants, primarily from India, Pakistan, Russia, and Africa, and they often found it hard to communicate with patients, many of whom didn’t speak English. Indeed, a study by outside consultants indicated that the doctors lacked the skills to deliver care in a multicultural environment.
In response, hospital administrators hired a firm to run costly training seminars. None of the doctors attended. They were too busy taking care of patients, they said. But then the administration tried another tack. It persuaded a doctor to work with a communications expert to prepare a presentation of a medical case in which a physician who didn’t speak Spanish had to diagnose a Hispanic patient who didn’t speak English. The presentation was then offered at “grand rounds,” the time when doctors gathered to discuss interesting cases. The session marked a breakthrough: engaged by the problem, the doctors began to learn about communicating with ethnically diverse patients. They even asked that future grand rounds include similar material.
The hospital succeeded in educating its doctors because it changed the frame it was using. Framing—the way a situation is characterized—can orient people’s thinking in either productive or unfruitful ways, and the frames that work best take into account the interests of those who are to be influenced. Three kinds of frames are particularly important: process frames, substantive frames, and behavioral frames.